TACOMA — On the night Manuel Ellis died, he and Tacoma police were left alone on the pavement without the calming presence of mental health professionals, even though Pierce County and Tacoma tout their crisis intervention resources.
It was a situation officers had seen before — with Ellis, who struggled with addiction and mental illness, and many others. And as they often do with people in crisis, officers responded with force.
Tacoma, adjacent to Western State Hospital and military bases, has a higher prevalence of mental illness than the state and national averages.
But Pierce County and Tacoma have been slow to invest in crisis-intervention services, despite advocates’ demands for greater commitment to easing the dangerous intersection of law enforcement and people in crisis.
Ellis’ family has filed a $30 million claim against Tacoma. The family of another man, William Langfitt, recently filed a $25 million claim against Pierce County over his March 2018 fatal shooting by a deputy responding to a mental health call. Langfitt, clutching a photo of his recently deceased grandfather, reportedly lunged into the deputy’s cruiser, prompting him to shoot.
Similar tragedies across the nation have prompted a moment of public reckoning for law enforcement, and have galvanized efforts to reform policing of people in crisis. In the Pacific Northwest, Ellis’ name is spoken alongside George Floyd’s and Breonna Taylor’s at protests against law enforcement’s inequitable treatment of Black people.
Police in Tacoma and across the country agree with mental health advocates that their interactions with people in crisis are fraught. “Resources are strained, officers are burned out or demoralized, people in crisis suffer injuries and are even killed by officers who were called to help them,” according a 2019 survey by two police training companies of more than 4,200 law enforcement personnel nationwide.
The programs that Tacoma and Pierce County established for mental health professionals and social workers to respond to police calls for assistance are seldom available, and aren’t usually deployed to quell tense interactions.
“Police are the only entity available to respond in person, 24 hours a day, seven days a week,” Detective Wendy Haddow, spokeswoman for the Tacoma Police Department, said. “All other responses are delayed.”
The consequences were evident in a Seattle Times review of Tacoma police reports over the past two and a half years involving officers’ interactions with people in crisis. Most were people of color, and in virtually every instance, they landed in emergency rooms with a litany of trauma, including police dog bites, torqued arms and, in one case, life-threatening injuries. Their illness and its side effects — homelessness, poverty — sometimes became criminalized with arrests and fines.
“It’s the most painful thing as a family member [of someone with mental illness], to call 911,” Lovey Offerle, president of the Pierce County chapter of the National Alliance on Mental Illness, said. “You don’t know if [the police] are going to come in with guns blazing, but you don’t know who else to call.”
Nationally, people with severe mental illness are 16 times more likely to be killed by police than someone without mental illness, and calls involving people with mental illness take up 21% of law enforcement officers’ time, according to NAMI. The problem is exacerbated by a shortage of treatment options.
Ellis’ death has shined a fresh spotlight on the consequences of such interactions. Pierce County Council member Derek Young, D-Gig Harbor, said Ellis’ case is a tragic example of missed opportunities to connect him with services, because political leaders haven’t prioritized those programs.
“The United States is starting out at one of the worst positions [in the world] in terms of treatment of people with behavioral health disorders,” Young said. “Washington state is one of the worst in the country, and Pierce County is the worst in the state. So we’re the worst of the worst of the worst.”
Ellis wasn’t diagnosed with schizophrenia until he was in his late 20s. By then, he’d come to know Tacoma-area police, not mental health therapists, as his primary crisis responders.
When he landed in prison for an identity theft conviction, Ellis told corrections staff that he had turned to methamphetamine, cocaine and marijuana for years to ease the anxiety and unwelcome thoughts that haunted him. He was sexually abused by a relative for years beginning at age 5, according to his family.
“By the time Manny was old enough to know what was really wrong with him, he was too far in his addiction to be able to combat both,” said his sister, Monet Carter-Mixon, 29.
Last September, Ellis unsuccessfully tried to rob a fast-food restaurant. He fled, and was confronted — nude, bleeding and confused — nearby by deputies, who used a stun gun on him when he didn’t hold still to be cuffed. Carter-Mixon said her brother’s mental breakdown should have signaled to deputies that Ellis needed help, not punishment.
The night Ellis died, police described him in a state of “excited delirium,” a catchall law enforcement term for people in an agitated state. A Times review of Tacoma police reports employing the term found that although officers routinely used force that required emergency room visits, the subjects were far less often involuntarily committed for psychiatric care, and a small fraction were ultimately charged with a crime.
The reports show officers girding for a fight and assuming they’re heading into a standoff with someone who they claim has near-supernatural powers.
In a Feb. 25 police report, an officer described “excited delirium” based on his training: “Alarming symptoms to include hyper aggression, superhuman strength and inability to feel or experience pain… Subjects in this state are often unable to control their exertion levels which can lead to cardiac arrest and death from fighting law enforcement or other first responders.”
Earlier this year, clerks at a 7-Eleven store in south Tacoma called police about a nude man washing himself with a soft-drink machine. He tried to grab cash from the register, and barricaded himself inside a walk-in cooler.
Before arriving, police, suspecting “excited delirium,” called for medics and an officer with a stun gun — but not mental health support. Officers found the 27-year-old Black man in his own feces, screaming and panicked. When he didn’t respond to commands to lie down, police used the stun gun, wrestled him to the ground and cuffed him. His night ended in the emergency room.
NAMI’s Offerle said the “excited delirium” term demonstrates a one-size-fits-all approach by law enforcement and it discounts nuanced differences among mental illnesses which, if understood, could help to de-escalate a situation nonviolently.
“(Officers) are programmed to survive. Part of their everyday mindset is to have their hand on their gun,” said Offerle, who helps train officers. “They’re coming into it relying on a survival instinct. There isn’t any thought about making it easier.”
That’s why Offerle favors reforms that would replace — or at least supplement — officers responding to people in crisis with trained mental health experts and health care workers, as Portland and Denver have, and was proposed in Seattle.
Trained mental health interveners can quickly identify the difference between schizophrenia and bipolar disorder, for instance, and more adeptly tailor their actions, she said.
“With trained mental health professionals and trained [emergency medical personnel] responding instead of police, you’d save a lot of lives,” Offerle said.
“Not so much a crisis team”
Instead, law enforcement agencies in Pierce County have an insufficient patchwork of resources to assist them on a call about someone experiencing a behavioral health crisis.
For Pierce County agencies outside of Tacoma, a Mobile Community Intervention Response Team, with a two-year budget of $1.7 million, takes referrals from officers and emergency personnel and pairs people in crisis with wraparound services to address their needs.
However, it’s “not so much a crisis team,” Pierce County spokeswoman Libby Catalinich said in an email, in part because the team’s focus is on long-term treatment.
And long wait times for the team to respond can negate its usefulness to defuse confrontations between officers and someone in distress. It took on average an hour and 12 minutes for the team to show up after being asked for assistance by officers, according to a May 2019 survey. Wait times ballooned to an average of one hour and 43 minutes in a survey last May.
Within the city of Tacoma, officers can call on the Mobile Outreach Crisis Team, which employs co-responders who can assist law enforcement by going to crisis situations.
But police in Tacoma have come to expect that they won’t get help from mental health experts to de-escalate a crisis at the scene. Since 2009, officers have requested the team’s assistance more than 700 times, and it has responded in person 42% of the time, according to Tacoma police.
And when the crisis team does show up, only about one-third of the people the crisis team connects with gets a “warm handoff” for any type of follow-up services, said Sylvia Riley, manager of Crisis Services at MultiCare, the company under contract to operate the program.
“We are so busy with new crises,” Riley said.
That leaves officers picking up the pieces of a fractured mental health system. In March 2019, Tacoma officers found a nude man dashing around a busy intersection, sweating heavily and “grunting instead of forming words,” according to a report. It was the third time within 24 hours that police had encountered him.
For the second straight day, the man was referred for involuntary commitment at St. Joseph’s Hospital and strapped to a gurney. In a report, Officer John Moses urged a longer stay than the usual 24-hour hold, but a nurse said, “They were just going to stabilize his condition then release him.”
Five weeks later, police found the same man on the same block where they’d picked him up before. He was clutching his hair and muttering to himself. Again, he was strapped to a gurney and temporarily committed.
There isn’t enough money for more responsive mental health resources, Tacoma-Pierce County Health Department spokeswoman Edie Jeffers said, because Pierce is the last large county in Western Washington that hasn’t adopted a sales tax of 1 cent on a $10 purchase to fund behavioral health and substance abuse programs.
Pierce County set aside $903,924 in its budget this year for its Mobile Community Intervention Response Team, which Pierce County Executive Bruce Dammeier lauded in his 2019 State of the County address as “successful” and “getting results.” However, 83% of that comes from grants; the county’s actual investment is less than $150,000.
Dammeier said the county’s strategy has been to leverage grants and private-sector partnerships to expand mental health services it couldn’t otherwise afford. “We’ve done it frugally,” he said.
He said the county was on track to add treatment beds early next year using mostly outside funding. He questioned whether a new tax would get the job done, unless its uses were well vetted and judged to be effective beforehand.
“Too many times, other jurisdictions have used those same moneys, and it’s been spread across their systems like peanut butter,” Dammeier said. “I’d argue they have the same problems we do today, and they have that tax.”
Tacoma did adopt a behavioral health tax in 2012, and has collected more than $40 million in total. But stepping in between police and mentally ill subjects hasn’t been a top priority. Since 2015, just 4% of the revenue has been spent on street-level crisis-response services, according to the city.
Instead, the Tacoma-Pierce County Health Department has prioritized reaching young people and intervening early, according to Jeffers.
“The demand for support services exceeds current supply, meaning some people cannot get the help they need,” she said.
There are other political obstacles to expanding mental health services. The Tacoma City Council in December unanimously rejected the zoning proposal for a new 105-bed psychiatric hospital in east Tacoma. The council member representing that district said, with Western State Hospital nearby, the neighborhood was already shouldering its share of the mental health burden.
The result, Offerle said, will be continued overreliance on emergency rooms. The judge in a legal challenge to the decision has ordered the council to reconsider.
“The city and the county need to own up,” Offerle said, beginning with authorizing more psychiatric beds and passing a county sales tax to fund services. “From our perspective, reducing contact with the police is the objective to reduce the chance of fatal encounters. Obviously, they’re doing something wrong here.”
“I have a grave”
When Ellis was released from prison in mid-2018 after a one-year sentence for identity theft, analysts for the prison system rated mental illness as the greatest barrier to his success.
The months that followed were marred by court entanglements and mounting fines. His family said these factors stoked his emotional distress, culminating in the September 2019 breakdown after his toddler daughter moved across the state with her mother.
The same report noted the treatment services he needed weren’t readily available in Pierce County, according to prison records obtained by The Seattle Times. By the time he began receiving the services, his fines had mushroomed beyond $4,000. His community corrections officer noted Ellis was becoming overwhelmed with obligations that seemed impossible to satisfy.
Ellis’ mother, Marcia Carter-Patterson, says she cried daily after his death but now she swallows the tears, outraged at Tacoma police, as well as the behavioral health care gaps that kept Ellis from getting immediate treatment when he needed it most.
“He didn’t get the care he needed,” Carter-Patterson said, her voice quivering.
“I have a grave. I have a little piece of grass, and that’s how I communicate with him now,” she said. “I don’t have him anymore.”
Correction: an earlier version of this story incorrectly identified MultiCare as the contractor for the Mobile Community Intervention Response Team in Pierce County. Instead, it is the contractor for the Mobile Outreach Crisis Team.